SIDS Awareness Month

October is Sudden Infant Death Syndrome (SIDS) Awareness month and a time to take a fresh look at how we can educate parents and caregivers on reducing the risk of SIDS. According to the Center for Disease Control and Prevention (CDC), about 3,500 infants died in the United States in 2014 of Sudden Unexplained Infant Death. (SUID).

SIDS is the sudden death of an infant less than 1 year old that cannot be explained after a thorough investigation that includes a complete autopsy, examination of the death scene, and a review of the medical history. This is the most commonly occurring unexplained death of infants

Another definition to be aware of is Accidental Suffocation and Strangulation in Bed (ASSB) which is the sudden death of an infant less than 1 year of age that can happen because of:

  • Suffocation by soft bedding such as when a pillow or covers an infant’s nose and mouth.
  • Overlay, or when another person rolls on top of or against the infant.
  • Wedging or entrapment which is when an infant is wedged between two objects such as a mattress and wall, bed frame, or furniture.
  • Strangulation which can happen when an infant’s head and neck get caught between crib railings.

The original Back to Sleep campaign has been updated by the CDC and the National Institutes of Health to become the Safe to Sleep campaign. The campaign works hand in hand with The National Action Partnership to Promote Safe Sleep (NAPPSS) and other organizations to bring awareness to and provide education on SIDS and ASSB prevention.

Current research supports the following recommendation for SIDS risk reduction:

  • Always place babies on their backs when putting them to sleep for naps and at night.
  • Use a firm sleep surface, such as a mattress in a safety-approved crib, covered by a fitted sheet.
  • Share your room with your baby, not your bed. Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else.
  • Keep soft objects, such as pillows and loose bedding, out of your baby’s sleep area.
  • The risk of SIDS is even greater when a baby shares a bed with a smoker. To reduce risk, do not smoke during pregnancy, and do not smoke or allow smoking around your baby.

Absent from many of the messages is encouraging mothers to breastfeed, which confers a 50% risk reduction of SIDS, and an even stronger protection if the mother is exclusively breastfeeding. Recognizing that the sleep separately message can be confusing or difficult for breastfeeding mothers, the United States Breastfeeding Committee and NAPPSS worked with the American Academy of Pediatrics to develop a more “breastfeeding friendly” safe sleep message.

On October 24, 2016 the American Academy of Pediatrics announced their Policy Statement: SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.

The following recommendations were given supporting the updated policy:

  1. Breastfeeding is recommended to reduce the risk of SIDS and to enhance the health and well-being of the infant and the mother. The AAP recommends exclusive breastfeeding for 6 months (no formula, nutritional liquids or solid foods). Newer research demonstrates that exclusive breastfeeding can reduce the risk of SIDS by as much as 70%.
  2. Skin to skin care is recommended for all mothers and newborns, regardless of feeding or delivery method for at least an hour after birth
  3. Room-sharing with the infant on a separate sleep surface is recommended. Keep infants in close proximity to parents for the first 6 to 12 months of life.
  4. The AAP recognizes that parents may fall asleep in bed after or during feeding their infant, so remove pillows, loose blankets, loose sheets and move the bed away from walls to prevent entrapment, and follow remainder of safe sleep recommendations.
  5. Avoid nighttime feeding on couches and arm chairs which are not considered safe sleep surfaces at any time for infants.
  6. It is important that anyone who cares for the infant puts the baby to sleep on their baby on the back. Prone sleeping (sleeping on the stomach) increases the risk of rebreathing the same air that is under the baby’s face which can increase the levels of carbon dioxide in their blood, not enough oxygen in their blood which can be potentially fatal.
  7. Creating a safe sleep surface. Recommendations from the National Action Partnership to Promote Safe Sleep (in partnership with the AAP) recommends to:
    “Use a firm sleep surface, such as a mattress in a safety-approved crib covered by a fitted sheet, to reduce the risk of SIDS and other sleep-related causes of infant death. Firm sleep surfaces with no other bedding or soft objects. Nothing soft such as pillows etc. should be placed under the baby. Appropriate surfaces can include safety approved cribs, bassinets, and portable play areas. Safety approved cribs are those that have been manufactured and sold since the requirements went into effect on June 28, 2011. They have been designed to have the spaces between the bars too small for a baby’s head to get through and get stuck. Standards for other safety approved spaces such as bassinets, portable play areas and side cars (attachment to an adult bed that provides a separate, but close safe space) have also been developed by the U.S. Consumer Product Safety Commission, the agency that tracks accidents and deaths with products and helps keep babies safe from products that can be harmful or cause accidents. For information on safety standards for sleep products , contact the Consumer Product Safety Commission at 1-800-638-2772 or http://www.cpsc.gov.”
  8. Avoid smoking, alcohol, and drugs during pregnancy and after birth.
  9. Avoid devices marketed to reduce risk of SIDS such as monitors, wedges, devices or specific mattresses.
  10. Swaddling does not reduce the risk of SIDS and in some cases may increase the risk for overheating and SIDs.
  11. Consider offering a pacifier at nap or bed time, after breastfeeding is firmly established (no specified time frame). If the baby is not breastfed, then a pacifier can be introduced as soon as the family desires.
  12. Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly.

Teaching points for prenatal or postpartum education on safe sleep include:

  • Exclusive breastfeeding significantly reduces the risk of SIDS.
  • Newborns and new parents sleep better when in close proximity.
  • Always place infants on their back for any sleep.
  • Do not allow any smoking in the home. Encourage and provide information to help women stop smoking during pregnancy.
  • Swaddling has not been shown to reduce the risk of and may increase the risk of overheating and SIDS. Avoid swaddling during times of sleep.
  • Do not use couches or chairs for nighttime feedings.
  • Do not co-sleep if either parent smokes or is using alcohol or drugs which can alter responding to the baby.
  • All surfaces that an infant might be sleeping on needs to be safe. This includes cribs, cots, playpens, and the parental bed (if the mother falls asleep while feeding). A safe sleep surface includes:
    • Firm mattress
    • Well-fitting sheet
    • No blankets or pillows
    • No bumper pads
    • Use only equipment designated and approved for infant sleep
    • No surface that can entrap an infant
    • No toys or pets sharing the same sleep surface
    • Avoid swaddling or clothing that can cause overheating

ICEA recently updated our Position Paper on Safe Sleep which is available on our web site.

References
http://pediatrics.aappublications.org/content/early/2016/10/20/peds.2016-2938
Centers for Disease Control and Prevention . (2015). Sudden unexpected infant death. Retrieved August 20, 2015, from http://www.cdc.gov/sids/aboutsuidandsids
https://awhonn.files.wordpress.com/2015/10/tips-for-nurses-teaching-safe-sleep-in-the-hospital-setting.pdf
Pease AS, Fleming PJ, Hauck FR, et al. Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. 2016-05-09 00:05:32 2016.
McKenna JJ, Gettler LT. There is no such thing as infant sleep, there is no such thing as breastfeeding, there is only breastsleeping. Acta Paediatr. Aug 21 2015
Carpenter R, McGarvey C, Mitchell EA, et al. Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies. BMJ Open. January 1, 2013 2013;3(5)

2018 Conference Abstract Deadline Extended

Share Your Expertise at ICEA’s Conference

Due to the recent fires and natural disasters around the world, there have been requests to extend the deadline for abstract submissions for our 2018 Conference. As a kind gesture, we’re extending the deadline to Monday, October 2.

The conference theme focuses on ICEA’s newly defined core values:

  • COMPASSION: We believe approaching maternity care with compassion and a nurturing spirit improves birth outcomes for all families.
  • COLLABORATION: We practice a culture of collaboration based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care.
  • CHOICE: We support freedom of choice by training professionals committed to empowering expectant families through informed decision making.

If you have an idea for a presentation centered around one or more of our core values, we’d love to hear it! We’re accepting submissions for concurrent sessions, hands-on skills stations, and poster sessions.

All abstracts must be submitted through the online system by 5:00 PM ET on October 2. Abstracts will then be reviewed by the ICEA Conference Committee. Share your expertise today!

If you have any questions about submitting your abstract, please contact the office.

Tips for Successfully Submitting Your Abstract

Submitting your abstract can be easily completed by following the steps below.

  • Create a profile on the submission site– please note that all submitters will be considered First-Time Users this year
  • Complete information about the author(s)-  including bio, headshot, and contact info
  • Share information about your session- including session description, session type, session level, track, etc.
  • Upload completed EPT and COI
  • Make sure to see the submission to fruition- you will receive an email confirmation for each session that you successfully submit

Submit Your Abstract

Credentials: What Are They and Why Do We Need Them?

What are credentials and why do we need them? Credentials include academic diplomas and degrees, identification documents, certifications, and badges to list a few. Theses credentials give proof of professional qualifications or background. Credentials may also inspire a level of respect. This is important to consider when you are deciding which school to attend or which organization to certify with. For example, when I decided to work toward my BSN (Bachelor of Science in Nursing) I looked for an accredited program – one that was reputable and authorized to educate nurses, one that was known for providing quality education.

These same considerations apply to professional certifications. ICEA began certifying childbirth educators in 1982. This year marks the 45th year that we have set the standard for birth professionals. ICEA has grown and developed programs that include Professional Childbirth Educator, Birth Doula, and Postpartum Doula programs. Our reputation for excellence has been recognized for decades within the communities of medical and birth professionals. Just this year, ICEA was awarded ANCC (American Nurses Credentialing Center) accreditation, meaning that we can now develop and present educational offerings for nursing continuing education.

Today, a variety of organizations offer credentials for childbirth educators and doulas, but few have the reputation for quality that ICEA enjoys. In the same way that hospitals seek accreditation from various agencies, they expect birth professionals to have credentials from organizations that they recognize and respect. ICEA’s longstanding history of family-centered, evidence-based care makes its credentials some of the most widely recognized and accepted – not only in the US, but around the world.  Our international reach continues to expand as we develop relationships with like-minded global partners.

ICEA ensures the quality of our credentials by requiring each candidate to pass an exam at the end of their course of study.  To maintain that quality each credentialed birth professional is required to obtain additional hours of continuing education in order to recertify. As research on best practices for pregnancy, birth, and breastfeeding continue to grow, we want to ensure that the knowledge of birth professionals certified by ICEA is current and evidence-based.

Becoming a credentialed birth professional is costly – in time, effort, and money – but it is worth it! ICEA credentials demonstrate your commitment to birth work. It is a verification of your professionalism, as well as the level and quality of your knowledge.

Recently, ICEA streamlined the membership and certification process. Our management company has worked diligently to make this process as smooth as possible, and we appreciate the ways in which you – the members of ICEA – have embraced this new framework. This tells us that you value what ICEA stands for – family-centered, evidence-based care – and that you value the ICEA credentials. We will continue to work hard to support and educate you as you flourish in supporting and educating childbearing families.

Flourishing for ICEA,

Debra Tolson, ICEA President and Bonita Katz, ICEA President Elect

Doula, Advocate, Activist

Most of us in birth work are well aware of today’s controversies in maternal health care: high cesarean rates, increasing maternal mortality, inadequate informed consent/refusal, lack of personal autonomy, and the list goes on.

These issues concern us – and they should.  We do this work because we care about mothers, babies, and their families.  And doulas are right in the middle of it all.  What is a doula’s role when a woman is in labor and it seems as though her wishes are not being honored? How does a doula advocate for her client?

Before we answer those questions we must remember some facts:

  1. In most instances, the woman chose her care provider and her place of birth. While it is possible to change both of those while she is in labor, that rarely happens.  And who is to say that the next care provider or place of birth will be an improvement? Most of the time you will have to work in the place and with the providers that the woman has already chosen.
  2. The woman is in labor. If a doula chooses to blatantly disagree with the care the woman is receiving she forces the woman into a decision.  Either she must choose her medical care provider over the doula (thus compromising the support the doula could offer) or she must choose the doula over her care provider (and so compromise her relationship with those delivering medical care).

So what can a doula do?  Encourage the mother and her partner to ask questions.  This does two things: First, it validates the soon-to-be parents as adults responsible for their own care and the care of their child.  This is their baby and their birth.  This is a key component of family centered maternity care.  The family makes the decisions that are right for them. Secondly, their questions may be an indication to their care provider that they need to communicate more clearly. Improving communication not only benefits the family, but it also improves customer satisfaction scores for the birth facility.

The doula herself can also ask questions. The recent update on doula care published by Evidence Based Birth (EBB) offers some welcome insight into client advocacy.  Good questions provide a way to ensure that the woman is aware of her options without negating the role of the healthcare provider. To quote the EBB article: “For example, if it looks like the provider is about to perform an episiotomy without the person’s consent: ‘Dr. Smith has scissors in his hand. Do you have any questions about what he is wanting to do with the scissors?’” Questions like this inform the woman (and her partner) and allows them to decide what to do with the information.

Doulas can advocate in this way for their clients, but how do doulas address those major controversies mentioned at the beginning of this blog? We must make a distinction between advocacy and activism.  Both are necessary, but they are approached in very different ways and in different settings.  Advocacy is described above and defined in the EBB article as “supporting the birthing person in their right to make decisions about their own body and baby.” Activism is taking on one or more of the big issues, researching and publishing the facts, and educating the public. Advocacy may take place in a clinical setting while the woman is in labor, but that is not the place for activism. Doulas advocate for one woman at a time.  Activism addresses an issue that affects many women.

Although a doula can be a birth activist, she must realize that activism may close some doors for her.  A birth facility may refuse her access if they do not appreciate her public stand on some issue.  Some have implied that birth workers must be activists in order to make effective change in maternal health care.  Activism will accomplish some change.  But so will the relationships that others build with health care providers.  The fact is that there are many ways to change the system.  We need activists… and we need advocates.  Let’s remember the difference and work within role we have chosen.

Resources
Dekker R (2017). Evidence on: Doulas. Evidence Based Birth. Retrieved August 23, 2017 from https://evidencebasedbirth.com/the-evidence-for-doulas/
Katz B (2017) One doulas difficult dilemma. International Journal of Childbirth Education. 32(3), p. 6.

Annual Membership Meeting Announcement

Notice is hereby given that ICEA will hold its Annual Membership Meeting on Thursday, October 19, 2017, at 1:30 PM ET via conference call. It is free for members to attend.

At this Annual Meeting, members will learn:

  • What the Board of Directors is working on
  • Who the 2018 Board of Directors will be
  • What has been achieved in 2017
  • What to look forward to in 2018

Time will also be given for members to pose questions to the board. Register now to be sent the call-in information. Space is limited to the first 200 registrants, so don’t delay. Register today!

If you are unable to attend the live call, a link will be sent out after the meeting for you to review.

Register Now

Open Letter to Fed Is Best Foundation

ICEA wants you to know that we are part of a coalition of 40 organizations that sent an open letter to the co-founders of the Fed Is Best Foundation on August 15. You will find the letter below.

Dear Dr. Castillo-Hegyi and Ms. Segrave-Daly:

We write to you as fellow advocates for the health and well-being of infants and their families. We believe that we share a common goal—to ensure that every baby gets the strongest start to life. It is in that spirit that we extend an invitation to you to discuss the concerns that you and your organization, the Fed Is Best Foundation, have raised with respect to our nation’s infant feeding recommendations and associated health care practices.

We believe the ground we have in common is far greater than the areas where we may have disagreement. For the sake of all children, mothers and families, we therefore seek ways to unite in a shared vision rather than engaging in divisive messaging. For example, we all agree that the health of the baby is the ultimate goal, that infant feeding is a highly personal decision, that the mother should be fully informed of her options in making this decision, that nobody has the right to impose their beliefs or values on another, and that no infant, mother, or family should suffer as a result of ineffective support or care practices. We also agree that many physicians and other health care providers need improved training and education to ensure the competency to properly diagnose and address infant feeding issues, and that improved continuity of care is needed to enable new mothers to access timely, integrated, and continuous care throughout the prenatal and postpartum periods.

That’s a lot of common ground to build on.

Where we seem to disagree is on the root cause behind the tragic stories that Fed Is Best has recently highlighted. That is where we would hope to engage in some honest and constructive dialogue to find shared messaging focused on providing the accurate and unbiased information families need to make their personal infant feeding decisions, along with the appropriate care and support they need to implement those decisions.

We believe that we can be most effective in serving moms and babies when we attack the root causes of problems, rather than each other. For this reason, we invite you to meet with us to talk about your concerns and discuss ways we can work together to ensure that no family has to endure the pain and heartbreak of a baby who doesn’t get the nutrition they need to thrive. We hope that you will take us up on our offer and look forward to receiving your response.

Sincerely,

1,000 Days
Academy of Breastfeeding Medicine
Alabama Breastfeeding Committee
American Association of Birth Centers
American Breastfeeding Institute
American Samoa Breast Feeding Coalition
Arkansas Breastfeeding Coalition, Inc.
Baby Cafe USA
Baby-Friendly USA, Inc.
Best for Babes Foundation
Breastfeeding Task Force of Nevada
California Breastfeeding Coalition
California WIC Association
Childbirth and Postpartum Professional Association
Eastern Kentucky Breastfeeding Coalition
Georgia Breastfeeding Coalition
Healthy Children Project, Inc.
Indiana Breastfeeding Coalition
International Board of Lactation Consultant Examiners
International Childbirth Education Association
Kansas Breastfeeding Coalition, Inc.
La Leche League USA
Louisiana Breastfeeding Coalition
Macomb County Breastfeeding Coalition
Massachusetts Breastfeeding Coalition
Michigan Breastfeeding Network
The Milk Mob
Mom2Mom Global
MomsRising
Mothers’ Milk Bank
Mothers’ Milk Bank Northeast
National Alliance for Breastfeeding Advocacy
National WIC Association
Nebraska Breastfeeding Coalition
New Hampshire Breastfeeding Task Force
New Mexico Breastfeeding Task Force
New York Statewide Breastfeeding Coalition, Inc.
NYC Breastfeeding Leadership Council, Inc.
Ohio Breastfeeding Alliance
Reaching Our Sisters Everywhere, Inc.
Rhode Island Breastfeeding Coalition
Texas Breastfeeding Coalition
United States Lactation Consultant Association
Vermont Breastfeeding Network

Only One Month Left to Submit Your Abstract

Share Your Expertise at ICEA’s Conference

Just one month remains for you to submit an abstract for ICEA’s 2018 Conference on April 19-21, in Louisville, Kentucky, USA!

The conference theme focuses on ICEA’s newly defined core values:

  • COMPASSION: We believe approaching maternity care with compassion and a nurturing spirit improves birth outcomes for all families.
  • COLLABORATION: We practice a culture of collaboration based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care.
  • CHOICE: We support freedom of choice by training professionals committed to empowering expectant families through informed decision making.

If you have an idea for a presentation centered around one or more of our core values, we’d love to hear it! We’re accepting submissions for concurrent sessions, hands-on skills stations, and poster sessions.

All abstracts must be submitted through the online system by 5:00 PM EST on September 15. Abstracts will then be reviewed by the ICEA Conference Committee. Share your expertise today!

If you have any questions about submitting your abstract, please contact the office.

Tips for Successfully Submitting Your Abstract

Submitting your abstract can be easily completed by following the steps below.

  • Create a profile on the submission site– please note that all submitters will be considered First-Time Users this year
  • Complete information about the author(s)-  including bio, headshot, and contact info
  • Share information about your session- including session description, session type, session level, track, etc.
  • Upload completed EPT and COI
  • Make sure to see the submission to fruition- you will receive an email confirmation for each session that you successfully submit

Submit Your Abstract